Clinical Background
Respiratory syncytial virus (RSV) is one of the most common causative agents of lower respiratory illnesses (including bronchiolitis and pneumonia) in infants and young children worldwide.
Epidemiology
- Prevalence
- Epidemics occur in late fall and winter - account for 5-15% of community acquired pneumonias
- Age
- In children 1 year of age or younger, 50% infected
- By age 3, 100% infected
- Immunity wanes with age and new disease may occur in patients older than 65 years
- Transmission - via respiratory droplets
Organism
- RSV, an enveloped RNA virus, is a member of the Paramyxoviridae family
Clinical Presentation
- Symptoms
- Children - varies from nasal congestion and upper respiratory tract disease to bronchiolitis, pneumonia, and severe respiratory distress and failure
- RSV can be fatal; sudden deaths, which occur in infants with respiratory disease, are often believed to be due to this virus
- Adults
- Infection in adults is generally mild, but RSV may cause severe pneumonitis in immunocompromised adults and the elderly
- In older children and adults, RSV can cause an influenza-like syndrome, bronchopneumonia or exacerbations of chronic bronchitis
- Children - varies from nasal congestion and upper respiratory tract disease to bronchiolitis, pneumonia, and severe respiratory distress and failure
Treatment
- Supportive
- In immunocompromised patients and children less than 2 years of age, antivirals are frequently used
Prevention
- RSV prophylaxis with immunoglobulin for children younger than 2 years of age is available for at-risk populations (preterm infants, patients with congenital heart disease)
See Also
